I'm curious to hear people's experience with stopping natrexone. Has anyone experienced feelings of withdrawal? What about maintaining either sobriety or control over drinking after stopping the nal?

Background for the question is that I've been taking it daily for about three months, but I've never much liked how I felt on it. As some of you know, my goal has always been achieving and maintaining abstinence rather than TSM extinction. I have been completely alcohol free for about 2.5 months. I feel incredibly good, and I'm very motivated to stick with my sobriety.

I realize three months is early in the game. Still, I'd like to drop the nal at the earliest opportunity and move ahead under my own steam. I'm not suffering severe side effects; it just makes me feel "off," and I am wary about continuing to use a drug like this unnecessarily. I'd appreciate hearing about other people's experience upon stopping, what prompted the decision, and what the long-term effect has been.

Thanks

I'm not following the question, really. If a person is following the Sinclair Method and has been AF for 2.5 months, they've already effectively stopped Nal. Nal is only taken when drinking.

If you're taking it for "abstinence" purposes, that's contrary to TSM and you could quite likely stop it at any time. But if you decide to have another drink ... THEN take the Nal an hour before.

YEs,....per PV's point,.....don't take it,...if you cave and want to drink, take a pill one hour previous.

From what I know, placebo and NAl for anti craving were the same (please correct if wrong board but i think I'm right). BEst Groucho, Jim

I don't blame you for the confusion. I am not doing a TSM program, and my doc's recommendations are even further from TSM. I've basically been taking it on a daily basis as a safety net against relapse. Doc insists I should plan to stay on it for about a year. That sounds nuts to me, particularly if I've got a few there just in case.

As far as I can tell, you're just wasting it if you take it on days when you don't plan on drinking or don't want to drink. Save your money and only take it before you take a drink. You've pretty much been doing TSM for the first part of your doctor-prescribed treatment (take nal + drink), and now it looks like you're able to be sober. I'd say if that's your goal, stick with staying dry and don't take your nal unless you happen to fall off the wagon. It won't stop your cravings, that's not what it's for.

I haven't read here or anywhere else about any bad effects of coming off of nal. I think your doc has kind of got you on a weird program!

Hi Groucho!

I'm sure you know that none of us here are giving medical advice. Only a licensed physician can do that.

To answer your question, allow me to do it by way of my own example. After I was cured at week 21ish, I started having more AF days per week; a couple at first; then a few; until months and months later at least 6 AF days per week. Since I use the TSM method as described in the book, I wouldn't take it at all on AF days. So, gradually over months of time, I only take it on the day I drink within any particular week. In the future, if I stop drinking for whatever reason at this stage of treatment, I'll never take another Naltrexone again. I don't feel any ill effects even if it's been 12 days between dosages.

I hope that answers your question.

Bob

Thanks for the input. I'm inclined to start tapering down myself.

Eskapa writes that Naltrexone does not work in conjunction with abstinence. The Cure for Alcoholism, pg 35.

Do you feel it's helping?

I don't give medical advice either. You might want to ask your doctor to explain the mechanism of naltrexone. My guess is he cannot. As Eskapa has mentioned here, naltrexone has no psychoactive properties, so I could not imagine why it would be necessary to taper off. I had to quit due to serious illness several months in and had no problem from suddenly quitting it. But you should discuss this with your doctor.

I frankly am glad you plan to stop taking it, since it at best a waste to take it while abstinent. The concern I have is that you are blocking your opioid receptors daily, and probably mildly extinguishing positive opioidergic activities from which you derive pleasure. If you stop, and focus on these activities for a few days (fine dining, sex, workout, etc.) you will derive the benefit of selective reinforcement for a few days while you still have a heightened number of active opioid receptors. It will be quick and easy to "relearn" these positive activities.

Please search "Alcohol Deprivation Effect" here and always have naltrexone at the ready for a relapse. Naltrexone works great to control drinking in the course of a post-ADE relapse. On the other hand, if you are comfortably abstinent, keep doing what works (and the naltrexone is not part of "what works" beyond a placebo effect).

Not one single published study shows naltrexone being effective as an anti-craving drug long-term. In fact, the large Finnish Heinala study shows that the naltrexone plus abstinence group fared worse than the placebo group. There is an abundance of information on this board if you'd like to learn. Here's a link to a summary of the Heinala study:http://www.thesinclairmethod.net/community/viewtopic.php?f=9&t=424&p=4352&hilit=heinala&sid=1f11df8753cfe22f2428f741db4fef45#p4352 You might also want to search "project COMBINE", which is the single largest study of alcohol treatment methods to date. The study showed naltrexone + drinking to be a highly effective treatment, while naltrexone + abstinence to be ineffective. Eskapa discusses in detail why, due to its pharmacological mechanism, naltrexone does nothing to promote abstinence.

I hope you keep posting here. The odds are low, but you just may be one of the fortunate few who can remain comfortably abstinent. We'll all cheer you on here! The actual experience of an actual person is more valid than a gazillion studies. Let us know how you're doing. All the best to you.

Groucho,

I've not taken NAL is about 2 months and didn't notice any issues with withdrawal.

As far as sobriety, I have no craving for AL so it is more that I just don't feel like drinking than choosing not to drink. I have plenty of NAL here, so if I wanted to drink I could. I just don't want to. I guess you could call this sobriety. I don't feel this way about it. In fact, I just don't really think about it much. I didn't drink hardly at all until I was in my early 30s (maybe 1-2 times/year), then developed a drinking problem in my mid-late 30s. I now feel like I did back when I was in my early 30s when it comes to drinking -- gotta love the TSM re-wiring.

One thing I would point out is that if you follow TSM to its ultimate conclusion, you'll slowly reduce your intake of NAL as your intake of AL does down. Even when I was drinking on a regular basis a couple months ago, I was only drink 1-2 times a week, so 1-2 NAL tablets a week. During this time, I noticed the side effects of taking NAL (fatigue for me) more than anything.

Q